In this article:
. Some studies report that this condition may occur in as many as 1 in every 250 newborns.
If your baby has this condition, try not to worry because it can be treated with simple measures.
What is Infant Torticollis?
Infant torticollis, sometimes called wryneck, happens when the neck muscles, particularly the sternocleidomastoid muscle (SCM), tighten or shorten. This causes your baby’s head to tilt or rotate to one side. The SCM is a large muscle that runs from behind the ear to the collarbone and breastbone. When it’s tight on one side, it pulls the head into an angled position, often with the chin pointing to the opposite side. This condition can be present at birth or develop later in infancy. It’s equally common in boys and girls and is generally painless for babies.Types of Infant Torticollis
- Congenital torticollis: This is the most common type, which is present at birth. It’s often linked to how your baby was positioned in the womb or events during delivery. You might not notice it until your baby is 6 to 8 weeks old, when they start gaining more head control.
- Acquired torticollis: This develops after birth, usually in the first four to six months or later. It can appear suddenly or gradually and may be caused by infections, injuries, or other underlying issues. Unlike congenital torticollis, it might cause discomfort or pain.
Symptoms of Infant Torticollis
Recognising the signs of torticollis in infants early can help you get the right support for your baby. Symptoms vary slightly depending on whether it’s congenital or acquired. Take a look at some of the common ones found in both types:- Your baby’s head tilts to one side, with their chin pointing to the opposite side.
- Limited ability to move their head or neck fully.
- One shoulder appears higher than the other.
- Neck muscles feel tight or stiff.
- Swollen neck muscles.
Symptoms Specific to Congenital Torticollis
- Small, soft, pea-sized lump in the SCM muscle (this may resolve within six months).
- Asymmetrical facial features, like one eye appearing lower than the other.
- A flat spot on the head (plagiocephaly) from lying in the same position.
- A preference for breastfeeding on one side or difficulty feeding on the other.
Symptoms Specific to Acquired Torticollis
- Headaches.
- Head tremors (shaking or trembling movements).
- Episodes of head tilting, sometimes with drowsiness, irritability, or vomiting.
Causes of Infant Torticollis
Understanding why torticollis happens can help you make sense of your baby’s condition. The causes differ depending on the two types:Causes of Congenital Torticollis
- Positioning in the womb: If your baby was cramped or in an unusual position (for example, a breech position), it can put pressure on the SCM muscle. This may cause the muscle to shorten.
- Birth trauma: The use of forceps or vacuum devices during delivery may strain the SCM muscle.
- Abnormal SCM development: In some cases, the SCM muscle doesn’t develop properly and leads to tightness.
- Hematoma: A collection of blood in the neck muscles can cause swelling and muscle shortening.
- Fibrosis: Abnormal thickening of the muscle tissue may contribute to the condition.
- Klippel-Feil syndrome: A rare birth defect where the neck vertebrae fuse, affecting muscle function.
Causes of Acquired Torticollis
- Throat swelling: Swelling from an infection, injury, or unknown cause can loosen tissues around the upper spine. This may cause vertebrae to shift and neck muscles to spasm.
- Vision problems (ocular torticollis): Issues with eyesight may cause your baby to tilt their head to see better.
- Gastroesophageal reflux disease (GERD): Acid reflux can lead to muscle tension and head tilting.
- Medication reactions: Certain medicines may trigger torticollis as a side effect.
- Scar tissue: Previous injuries or surgeries may cause muscle tightness.
- Arthritis in the neck: Though rare in infants, this can contribute to muscle spasms.
- Sandifer syndrome: A movement disorder where acid reflux in babies causes abnormal neck and body muscle spasms.
- Grisel’s syndrome: A rare condition following head, neck, or throat surgeries, leading to muscle issues.
Diagnosing Infant Torticollis
A visit to your baby’s healthcare professional is important if you suspect torticollis. The doctor will diagnose it through a physical exam, checking how far your baby can turn their head and looking for tight or swollen neck muscles. They may check for a lump in the SCM muscle, which is common in congenital cases. To rule out other conditions or confirm the diagnosis, they might recommend:- X-rays: To check for bone or spine abnormalities.
- Computed tomography (CT) scan or magnetic resonance imaging (MRI): To get detailed images of the neck and spine.
- Ultrasound: To examine the neck muscles for lumps or swelling.
- Electromyogram (EMG): To identify which muscles are affected.
- Blood tests: To rule out infections or other conditions.
Treatment Options for Infant Torticollis
The positive news is that torticollis in infants can be treated. Most cases improve with simple at-home exercises, but some may need extra support. Its treatment involves:At-Home Stretching and Positioning
- Infant torticollis exercises: Your healthcare professional will show you how to gently stretch your baby’s neck to loosen the tight SCM muscle and strengthen the weaker side. Do these exercises several times a day and gradually increase the movement. Start when your baby is 2 to 6 months old for the best results.
- Tummy time: Lay your baby on their stomach for 10 to 15 minutes, four times a day, on your lap or chest. Position their head to turn away from the tilted side using your voice or toys to encourage them to look towards you. This strengthens neck and shoulder muscles and helps prevent flat head syndrome.
- Feeding adjustments: Offer the bottle or breast in a way that encourages your baby to turn their head away from the favoured side. For example, if they tilt to the left, feed from the right to stretch the tight muscle.
- Sleep positioning: Place your baby on their back (to reduce the risk of SIDS) with their torticollis side facing the wall. They’ll naturally turn their head to look into the room, stretching the tight muscle.
- Encourage head movement during playtime: Use toys, sounds, or lights to draw your baby’s attention to both sides, encouraging them to turn their head in the opposite direction of the tilt.
Physical Therapy
Your healthcare professional may refer you to a physical therapist if at-home exercises aren’t enough. They’ll assess your baby every 2 to 4 weeks, measuring head movement and tracking progress. They may use techniques like heat therapy, massage, or traction to relieve muscle tightness. They’ll also monitor for flat head syndrome and suggest ways to reduce it.Surgical Options
Surgery is rarely needed and is considered only if torticollis persists despite other treatments. It involves lengthening the SCM muscle and is generally delayed until your child is preschool age. This corrects the head tilt and improves movement.Potential Complications of Infant Torticollis
Torticollis in infants can lead to certain complications if left untreated, but early treatment can prevent these. Possible issues may include:- Facial differences: Limited muscle movement may cause uneven facial features.
- Flat head syndrome or plagiocephaly: Constant pressure on one part of the skull can flatten it, as the baby’s skull is soft and moldable.
- Motor skill delays: Reduced head control can affect sitting, crawling, or walking.
- Feeding difficulties: Trouble turning the head may make breastfeeding or bottle-feeding harder on one side.
- Poor balance: Limited neck movement can impact coordination.
- Vision or hearing problems: Restricted head movement may affect how your baby tracks objects or hears sounds.
When to Seek Medical Help
Reach out to your baby’s healthcare professional if:- Stretching exercises and positioning don’t improve the head tilt after a few months.
- Your baby develops new symptoms, such as severe neck pain, head tremors, drowsiness, irritability, or vomiting.
- Torticollis appears after an injury or illness, as this could indicate a more serious issue.
- You notice signs of flat head syndrome or other complications.
FAQs on Infant Torticollis: Symptoms, Causes, and Treatment Options
- What are the common symptoms of infant torticollis?
Common signs include the baby’s head tilting to one side with the chin pointing the other way, limited neck movement, one shoulder appearing higher, tight or swollen neck muscles, and sometimes a small lump in the SCM muscle. - How do doctors confirm a diagnosis of infant torticollis?
Doctors will check your baby’s neck movement and muscle tightness through a physical exam. Imaging tests like X-rays or ultrasound may also be used to look at the muscles and bones. - What complications can arise if infant torticollis is left untreated?
Untreated torticollis can cause facial asymmetry, plagiocephaly, delayed motor skills, or feeding difficulties due to limited head movement.
